Which COVID-19 patients should be recommended for home isolation and which should be hospitalized? Predictors of disease progression for mild COVID-19 patients

Abstract

Background/aim: Each country has different treatment and home isolation recommendations regarding the management of mild COVID-19 patients, and there is not yet a standard approach. The aim of this study is to determine which patients are suitable for home isolation by identifying the variables that predict the progression of the disease in mild COVID-19 patients. Materials and methods: This prospective observational study included laboratory confirmed mild COVID-19 patients older than 18 years. The primary outcome of the study was the disease progression in mild COVID-19 patients. A multivariate regression model was created according to the results of univariate analyses. Results: A total of 254 patients included in the study. Median age of the patients was 34.5 years (27–42), and 132 (52%) of them were male. COVID-19 compatible thoracic computed tomography appearance (P<0.001, HR=6.58, 95% CI=2,60-16,65) and advanced age (P=0.008, HR=1.07, 95% CI=1.02-1.13) were significantly associated with the progression of the disease, and the use of hydroxychloroquine (P=0.002, HR=0.09, 95% CI=0.02-0.32) was significantly associated with a decrease in the disease progression. Conclusion: The advanced age and COVID-19 compatible thoracic computed tomography appearance were associated with progression of the disease, while hydroxychloroquine treatment was associated with decreased progression in mild COVID-19 patients.

Keywords

• 2019 novel coronavirus disease
• SARS-CoV-2 infection
• COVID-19 pandemic
• Disease progressions
• Clinical deterioration

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